20120641 Ver 1_Shoreline Stabilization_20120628

20 1 2464 1
The following is an abbreviated application form for those applying for a 401 Water Quality
Certification to impact FERC (Federal Energy Regulatory Commission) regulated lake shore or
bottom under the U.S Army Corps of Engineers Permit GP30 This Application cannot be used
for wetland or stream impacts Please provide five (5) copies of this application and supporting
information as well as a non - refundable application fee to the Division of Water Quality of $240 00
for unpacts to lake bottom of less than 1 acre and $570 00 for impacts to lake bottom of greater or
equal to 1 acre
Applications should be sent to
Division of Water Quality 401 Oversight/Express Review Permitting
1650 Mail Service Center
Raleigh, NC 27699 1650
L Applicant Information
A ,r
J t' I D
1 Owner /Applicant Information ►.�
Name 7?0 6,F2 7171.9
Mailing Address 5 S' At4 kJ+yGee Awu !Xe
979�Tr_ ,�&AS . ill G
.Z.B4v 3 D
Telephone Number / - S3 7- t f 3 .Q_ 1 Fax Number
E -mail Address 12M, am
2 Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the owner /applicant)
Name
Company Affiliation
Mailing Address 8 &I -
Telephone Number Fax Number @�
E mail Address
II Protect Information
Attach a vicinity map clearly showing the location of the property with respect to local landmarks such
as towns, rivers, and roads Also provide a detailed site plan showing property boundaries and
development plans in relation to surrounding properties You may use the diagram below to make a
hand sketch of your protect. Also see the example below for guidance Both the vicinity map and site
plan must include a scale and north arrow The footprints of all buildings impervious surfaces or other
facilities must be included

1 Location
County C !a.4 awe td- Nearest Town Te,
Subdivision name or site address (include phase/lot number) #ALL- t Jam. t-t- LAXIh A
Directions to site please include road numbers, landmarks, etc (This is not necessary if an adequate
vicinity map is included) 'PXY M rra r
Al 5A)l A %a 1=a.4 -& Ad <'ca CAAAE 5 rMiK 14C To
'P4 ?� ECAV4F'E Art'W 4k
2 Describe the existing land use or condition of the site at the time of this application
3 Property size (acres) G, V5
4 Nearest body of water ( stream /nver /sound/ocean/lake) LA r" a r- 4 r=PYt/ 55
5 Describe the purpose of the proposed work 5". t- T/zd- dAx� JK . f
It'- t,e�7r✓L �f c1Yc -�- �--1�- r '�
6 List the type of equipment to be used to construct the project E r g 4- -iC.tD s
7 Amount of impact (including all excavation, backfill np rap, retaining walls etc ) below the
normal pool lake level in square feet or acres
5- 7- t '-z 4- = (030 sie
8a Amount of impact (including all clearing back fill excavation, np rap retaining walls etc )
above the normal pool lake level and 50 feet land ward in square feet or acres
SQtr7
8 b Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance) -;Z,3 -rRees , /V Y /-;Ec fR'J,
^� Z -3 ap �- � v !z' M., d /II f'L a i h "d-I i WO& a l /IYMGJ�G� ✓S
2c,ti,W�- S Tizec -s Aav GA, 57.ecc l #4 AnI9 CzIz- ) r&ee-
rtes ?,. it -r)'-4 /V-011i P' Y 27
d
Appl cant/Agent's Signature Date
(Agent s signature is valid only if an authorization letter from the applicant is provided )

I Dumb L Reld cart /fy that MIs plat was drawn by ma
from an actual survey made by me f deed dem*hon
recorded InP811 PAGET08/ that the SN CAROE' \
boundanas not surveyed are dearly lad sated os drawn O� �tss ►o iy
from /nformat/on found In OB Page Z le *
,r \
that the ratio of preds/on as calculated us f 14M SEAL
that this plat was 3765 \
p prepared m accordance with the GS 47 3� r� �
as amended O 401
WOness my 01'lg4ml slgnatare reglstrat tuber and seal 9� ��
this the 14 TNdoy oFJUI Y?008 At t �
Reg/stration Number L 376
rt�tl PLS
REF Plat Book 22 Page 05
LOT 13
JOHN E BOWL ES FAMIL Y TRUST
1592- 1030
rn
o TO THE 1005 CONTOUR ELM
as o
o a £ FLOOD EASEMENT RESERVED B
Z z POWER CO ALONGLAKERHOM
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orn
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\\ '� DWFLL/NOSETPACK 75 54 - , �, N
/i VIOLATION { ° N o
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pot 76 SEPTIC TANK
O EON o 11 \
ZG. � O - - - �g stDE sEreACK
\ P�Z� 1a \ G top q0 SIDE SETBACK - 994 \ _
S 79 °55 2 DRA NAGf EASEgr LINE - --1 - -- o
400 -'a rRANS RESERVED ALON� L_ - �� o
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o s SAMS iYAY y1 y$ �9 EARL HINDMAN Ij
5 ti 1599 - OS LOT 11
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,� \\ REF Plat Book 22 Page 05
NUR�BAYOR \ 'G� \
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LEGEND
EIP EXISTIN61RON
VICINITY MAP - NOT Tb SCALE GG NIP NEW IRONPIN
ANY AL T£ RATIONS OR REUSE OF MIS PLAT WITHOUrmEWRITTEN \ 'Goo, tl:� \
PERMI SSIONOf THE UNDERS IMED SURVEYOR ISSTRIMYPRON /BITTED \ O 25 50 100 125
NOTES \� \
TNEREARENO KNOWN ACES HORIZONTAL CONTROL MONUMENTS GRAPHICAL SCAL E 1 = 50
WITHIN1000OFTHISSIT&( SEE REM SHOWNJIP.811PAGEMFORMDTIE , TOWN OFSAWM11t5 MIN& CLASSIFICATION F
ALL MEASUREMENTS ARE HORIZONTAL \ MINIMUM 8010M SEMAX WITH PURL IC WA I
AREAS CAL CULA TED USINGTHECOORDINATEMETHOD \ 40 FRONT
TMI S PROPERTY LIES WITHIN CALDWELL COMM PLANNINGAREAAID 15 SIDE
IS SMUT TO ITS MIXABLE OIOINACESALONG WITH ANY APPL ICABLERESTRICA/016 ` 18 SIDE AT5 TREE T
THIS PLAT DOES NOT CREATEANYNEW PARCELS OR RIGHT Of WAYS BUT ISA BOUNDARYAND
LOCATIONSIA9VEYOFTHEPARCELRERREN CED 35 REAR
s0 WATERFRONT

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